Patterns of failure at the instrument-tissue interface

Background The effect of jaw design on grip security and tissue trauma is p oorly understood. This project establishes an in vitro model of the instrum ent-tissue interface. Materials and methods. Aluminum jaws with teeth of differing size and shape gripped fresh sheep stomach with variable apposing (squeeze) pressure. The tissue was extracted at a rate of 50 mm/min until either the grip or the t issue failed, The load at which the grip failed, the maximum (peak) load ge nerated, and the mode of failure were noted. The data were analyzed using A NOVA and a post hoc Duncan's multiple range test when appropriate. Results. Increasing the apposing pressure increased grip security. Grip sec urity of 1- and 2-mm pitch teeth were significantly greater than for plane jaws and smaller-pitch teeth (P < 0.001), Of the wave pattern jaws, 2-mm pi tch waves also had significantly greater grip security than plane jaws and smaller pitch waves (P < 0.01). Wave pattern jaws produced significantly le ss tissue trauma than teeth (P < 0.0001). Conclusions. Increasing the size of instrument teeth increases grip securit y but at the expense of tissue trauma. Wave pattern jaws result in signific antly less tissue trauma than teeth. This model measures grip security prec isely and allows for comparison between jaws of different patterns. (C) 200 0 Academic Press.